RESUMO
Increasing evidence indicates that exposure to traumatic events predisposes individuals to depressive symptoms as well as to emotional and psychophysiological symptoms covered under the diagnostic criteria of posttraumatic stress disorder (PTSD). Trauma exposure history and PTSD symptoms would, therefore, be expected to be more common in a depressed population than in a nondepressed group. To examine the association between trauma exposure (trauma load), dissociation, and depression, we administered clinical interviews and an assessment package derived from existing instruments (including the Dissociative Experiences Scale; DES) to 101 veteran patients with histories of clinically significant depression and a comparison group of 49 medical patients with no history of depression. The depression group had experienced significantly higher numbers of traumatic incidents, had higher average DES scores, and more frequently met diagnostic criteria for PTSD. The findings support the argument for a causal or predisposing effect of trauma in the expression of clinically significant depression.
Assuntos
Transtorno Depressivo/diagnóstico , Transtornos Dissociativos/diagnóstico , Acontecimentos que Mudam a Vida , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Assistência Ambulatorial , Criança , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Abuso Sexual na Infância/psicologia , Abuso Sexual na Infância/estatística & dados numéricos , Comorbidade , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Transtornos Dissociativos/epidemiologia , Transtornos Dissociativos/psicologia , Feminino , Hospitalização , Hospitais de Veteranos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Veteranos/estatística & dados numéricosRESUMO
Much of the literature on the psychiatric consequences of stress has focused on wartime combat trauma. However, traumatic events also frequently occur in civilian life. Controlled studies on the psychiatric effects of noncombat trauma were reviewed and a meta-analysis of these data was conducted. Generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), substance abuse, phobia, and major depressive disorder (MDD) were significantly elevated compared with a pooled control group, whereas panic disorder and dysthymic disorder were not significantly increased. These data suggest that the psychiatric effects of civilian trauma include both anxiety and depressive disorders. The results are strikingly similar to those reported in combat veterans, suggesting that severe trauma, even in very different populations, may be associated with similar psychopathology.
